Neomycin (EENT)
Jeneng merek: Casporyn HC
Kelas obat:
Agen Antineoplastik
Panganggone Neomycin (EENT)
Infeksi Ophthalmic Bakteri
Digunakake ing kombinasi tetep karo anti-infèksi liyane (yaiku, polymyxin B lan bacitracin; polymyxin B lan gramicidin) kanggo perawatan topikal saka infèksi dangkal ing mripat (contone, conjunctivitis, keratitis , keratoconjunctivitis, blepharitis, blepharoconjunctivitis) sing disebabake dening bakteri sing rentan.
Konjungtivitis bakteri sing entheng lan akut kerep ilang kanthi spontan tanpa perawatan anti-infèksi. Senajan anti-infèksi ophthalmic topikal bisa nyepetake wektu kanggo resolusi lan nyuda keruwetan lan risiko komplikasi, supaya ora nggunakake anti-infèksi topikal kanthi sembarangan. Perawatan konjungtivitis bakteri akut umume empiris; nggunakake antibakteri ophthalmic topikal spektrum sing amba biasane dianjurake. Pewarnaan in vitro lan / utawa kultur bahan konjungtiva bisa dituduhake ing perawatan konjungtivitis purulen sing berulang, abot, utawa kronis utawa nalika konjungtivitis akut ora nanggapi perawatan topikal empiris awal.
Amarga keratitis bakteri bisa digandhengake karo mundhut sesanti sabanjure minangka akibat saka jaringan parut kornea utawa irregularities topografi lan amarga keratitis bakteri sing ora diobati utawa abot bisa nyebabake perforasi kornea kanthi potensial kanggo endophthalmitis lan bisa ilang mripat, Manajemen optimal kalebu evaluasi lan diagnosa kanthi cepet, wiwitan perawatan sing tepat, lan tindak lanjut sing cocog. Perawatan keratitis bakteri sing dipikolehi masyarakat umume empiris; nggunakake antibakteri ophthalmic topikal spektrum sing amba biasane dianjurake. Anti-infèksi suBConjunctival bisa uga dibutuhake yen scleral nyebar utawa perforasi wis cedhak. Pewarnaan in vitro lan / utawa kultur materi kornea dituduhake ing manajemen keratitis sing nglibatake infiltrat kornea sing tengah, gedhe, lan ngluwihi stroma tengah nganti jero; nalika keratitis kronis utawa ora responsif kanggo perawatan anti-infèksi topikal spektrum sing amba; utawa nalika fitur atipikal nuduhake infeksi jamur, amebik, utawa mikobakteri.
Infeksi Otik Bakteri
Digunakake ing kombinasi tetep karo colistin lan hydrocortisone acetate utawa ing kombinasi tetep karo polymyxin B lan hydrocortisone kanggo perawatan topikal saka infèksi dangkal saluran auditory eksternal (otitis externa) sing disebabake dening bakteri sing rentan. . Uga digunakake kanggo perawatan topikal infeksi mastoidectomy utawa rongga fenestrasi sing disebabake dening bakteri sing rentan.
Otitis eksterna akut sing nyebar lan ora rumit ing pasien sing sehat biasane diobati kanthi terapi topikal (contone, anti-infektif otik utawa antiseptik kanthi utawa tanpa kortikosteroid otik). Tambahan karo terapi anti-infektif sistemik yen pasien duwe kondisi medis sing bisa ngrusak pertahanan host (umpamane, diabetes mellitus, infeksi HIV) utawa yen infeksi wis nyebar menyang pinna, kulit gulu utawa rai, utawa menyang jaringan sing luwih jero kayata kedadeyan karo otitis eksterna maligna. Otitis eksterna ganas minangka infeksi invasif, sing bisa ngancam nyawa, utamane ing pasien immunocompromised, lan mbutuhake diagnosis lan perawatan kanthi cepet kanthi anti-infèksi sistemik.
Inflamasi Okular
Persediaan ophthalmic kombinasi tetep sing ngandhut neomycin, polimiksin B, lan deksametason utawa preparat ophthalmic kombinasi tetep sing ngandhut neomycin, polimiksin B, bacitracin, lan hidrokortison utawa hidrokortison asetat digunakake kanggo perawatan topikal. kondisi okular responsif kortikosteroid nalika kortikosteroid dituduhake lan infèksi okular bakteri superfisial utawa risiko infèksi kuwi ana.
Sanajan pabrikan nyatakake yen nggunakake preparat ophthalmic kombinasi tetep sing ngemot anti-infektif lan kortikosteroid bisa dituduhake ing kondisi inflamasi okular nalika risiko infeksi okular superfisial dhuwur utawa nalika jumlah bakteri sing bisa mbebayani bakal ana ing mripat, para ahli nyatakake supaya ora nggunakake preparat kasebut ing pasien karo konjungtivitis bakteri amarga bisa nyebabake infèksi.
Elinga yen nggunakake preparat ophthalmic kombinasi tetep sing ngemot anti-infektif lan kortikosteroid bisa uga topeng tandha klinis infeksi bakteri, jamur, utawa virus; nyegah pangenalan ineffectiveness saka anti-infèksi; lan / utawa nambah IOP. (Deleng Panganggone Kombinasi Tetap sing Ngandhut Kortikosteroid miturut Ati-ati.)
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Carane nggunakake Neomycin (EENT)
Administrasi
Administrasi Oftalmik
Kombinasi tetep neomycin, polimiksin B, lan bacitracin: Olesake ing mripat minangka salep ophthalmic.
Kombinasi tetep neomycin, polymyxin B, lan gramicidin: Aplikasi topikal ing mripat minangka solusi ophthalmic.
Kombinasi tetep neomycin, anti-infèksi liyane (yaiku, polimiksin B kanthi utawa tanpa bacitracin), lan kortikosteroid (yaiku, deksametason, hidrokortison, utawa hidrokortison asetat): Aplikasi topikal ing mripat minangka salep ophthalmic utawa penundaan.
Mung kanggo panggunaan ophthalmic topikal; aja nyuntikake subconjunctivaly utawa langsung menyang kamar anterior mripat.
Aja nganti kontaminasi tip wadhah karo bahan saka mripat, tlapukan, driji, utawa sumber liyane.
Administrasi Otik
Kombinasi tetep neomycin, colistin, lan hydrocortisone acetate: Aplikasi topikal menyang saluran kuping minangka suspensi otik.
Kombinasi tetep neomycin, polimiksin B, lan hidrokortison: Aplikasi topikal menyang saluran kuping minangka solusi otic utawa suspensi.
Persediaan otik mung kanggo panggunaan otik topikal; ora digunakake ing mripat.
Kali kuping sing resik lan garing sadurunge ditrapake.
Goyang suspensi otic sakdurunge digunakake.
Gorong karo kuping sing kena munggah. Lebokake jumlah solusi otic utawa suspensi sing cocog menyang kuping; njaga posisi iki nganti 5 menit kanggo nggampangake penetrasi menyang saluran kuping. Baleni prosedur kanggo kuping ngelawan yen perlu.
Yen saluran kuping sempit utawa edematous lan ana kuwatir manawa pangiriman obat bisa diganggu, coba lebokake sumbu katun menyang saluran kuping lan disiram nganggo persiapan otik. Produsen nyatakake supaya sumbu tetep lembab kanthi nambahake solusi otic utawa suspensi tambahan saben 4 jam lan ngganti sumbu saben 24 jam. Para ahli nyatakake yen sumbu sing ora perlu sawise busung kanal kuping suda, sing bisa kedadeyan sajrone 24 jam utawa sawetara dina sawise perawatan topikal diwiwiti.
Aja nganti kontaminasi ujung wadhah kanthi bahan saka kuping, driji, utawa sumber liyane.
Dosis
Kasedhiya minangka neomycin sulfate; dosis ditulis ing syarat-syarat basa.
Pasien Pediatrik
Infeksi Otik Bakteri OtikNeomycin, colistin, lan hydrocortisone acetate ing bocah-bocah ≥1 taun (suspensi otik): Tetesake 4 tetes ing kuping sing kena pengaruh 3 utawa 4 kaping saben dina nganti 10 dina.
Neomycin, polymyxin B, lan hydrocortisone ing bocah-bocah umur ≥2 taun (solusi otik utawa suspensi): Lebokake 3 tetes ing kuping sing kena pengaruh 3 utawa 4 kaping saben dina nganti 10 dina.
Durasi optimal perawatan topikal otitis eksterna akut ora ditemtokake, nanging biasane dianjurake 7-10 dina. Pangobatan sing cocog kudu nambah gejala (otalgia, pruritus, fullness) sajrone 48-72 jam, sanajan resolusi gejala bisa nganti 2 minggu. bocah-bocah ≥2 taun (suspensi ophthalmic): Tetesake 1 utawa 2 tetes ing kantung konjungtiva mata sing kena pengaruh nganti 4-6 kaping saben dina. Ing penyakit sing abot, nyemprotake 1 utawa 2 tetes saben jam ing wiwitan, banjur nyuda dosis kanthi nyuda frekuensi administrasi nalika inflamasi suda.
Yen ora ana perbaikan sawise 48 jam, evaluasi maneh pasien. (Deleng Panganggone Kombinasi Tetep Ngandhut Kortikosteroid ing Ati-ati.)
Dewasa
Infeksi Ophthalmic Bakteri OphthalmicNeomycin, polymyxin B, lan bacitracin (salep ophthalmic): Olesake ing mripat sing kena pengaruh. saben 3 utawa 4 jam kanggo 7-10 dina, gumantung saka keruwetan infeksi.
Neomycin, polymyxin B, lan gramicidin (solusi ophthalmic): Lebokake 1 utawa 2 tetes ing mripat sing kena pengaruh saben 4 jam suwene 7-10 dina. Kanggo infèksi abot, bisa instill nganti 2 tetes saben jam.
Durasi biasa perawatan anti-infèksi topikal kanggo konjungtivitis bakteri yaiku 5-10 dina; 5-7 dina biasane cukup kanggo konjungtivitis bakteri sing entheng.
Infeksi Otik Bakteri OtikNeomycin, colistin, lan hydrocortisone (suspensi otic): Lebokake 5 tetes ing kuping sing kena pengaruh 3 utawa 4 kaping saben dina nganti 10 dina.
Neomycin, polymyxin B, lan hydrocortisone (solusi otik utawa suspensi): Lebokake 4 tetes ing kuping sing kena pengaruh 3 utawa 4 kaping saben dina nganti 10 dina.
Durasi optimal perawatan topikal otitis eksterna akut ora ditemtokake, nanging biasane dianjurake 7-10 dina. Pangobatan sing cocog kudu nambah gejala (otalgia, pruritus, fullness) sajrone 48-72 jam, sanajan resolusi gejala bisa nganti 2 minggu. salep ophthalmic): Lebokake salep kira-kira 1,25 cm (½ inci) ing kantung konjungtiva mata sing kena pengaruh nganti 3 utawa 4 kaping saben dina.
Neomycin, polymyxin B, lan deksametason (suspensi ophthalmic): Tetesake 1 utawa 2 tetes ing kantung conjunctival saka mripat sing kena pengaruh nganti 4-6 kaping saben dina. Ing penyakit sing abot, tetesake 1 utawa 2 tetes saben jam ing wiwitan, banjur taper dosis kanthi ngurangi frekuensi administrasi nalika inflamasi suda.
Neomycin, polymyxin B, bacitracin, lan hydrocortisone utawa hydrocortisone acetate (salep ophthalmic): Aplikasi menyang mripat sing kena pengaruh saben 3 utawa 4 jam, gumantung saka keruwetan kondisi.
Yen ora ana perbaikan sawise 48 jam, evaluasi maneh pasien. (Deleng Panganggone Kombinasi Tetep Ngandhut Kortikosteroid ing Ati-ati.)
Watesan Resep
Pasien Anak
Infeksi Otik Bakteri OtikNeomycin, colistin, lan hydrocortisone acetate ing bocah-bocah ≥1 taun: Maksimal 10 dina terapi.
Neomycin, polymyxin B, lan hydrocortisone ing bocah-bocah ≥2 taun: Maksimal 10 dina terapi.
Dewasa
Infeksi Otik Bakteri OtikNeomycin, colistin, lan hydrocortisone acetate: Terapi maksimal 10 dina.
Neomycin, polimiksin B, lan hidrokortison: Terapi maksimal 10 dina.
Populasi Khusus
Ora ana rekomendasi dosis populasi khusus.
Pènget
Kontraindikasi
Pènget/PanandhapReaksi Sensitivitas
Reaksi Hipersensitivitas
Iritasi lokal lan reaksi alergi kacarita; reaksi hipersensitivitas sing luwih serius, kalebu anafilaksis, jarang dilapurake .
Anti-infektif topikal, utamane neomycin, bisa nyebabake sensitisasi kulit.
Sajrone nggunakake jangka panjang, priksa pasien kanthi periodik kanggo tandha-tandha sensitisasi.
Preparat oftalmik: Sensitivitas bisa katon minangka ruam, pruritus, edema konjungtiva lan tlapukan, eritema konjungtiva, utawa ora bisa waras.
Preparat otik: Sensitivitas bisa diwujudake minangka reddening tingkat rendah kanthi bengkak, scaling garing, pruritus, utawa gagal waras.
Yen ana tandha utawa gejala sensitivitas, mandhegake obat kasebut. Gejala biasane suda kanthi cepet sawise persiapan mandheg.
Pasien alergi marang siji preparat kombinasi tetep kudu ngindhari preparat sing ngemot obat komponen apa wae. Cross-allergenicity ana ing antarane aminoglikosida; pasien alergi neomycin bisa uga alergi marang aminoglikosida liyane (contone, gentamicin, paromomycin, streptomycin).
Sensitivitas SulfitSawetara preparat otik kombinasi tetep ngandhut kalium metabisulfit, sawijining sulfit sing bisa nyebabake reaksi alergi (kalebu anafilaksis lan episode asma sing ngancam nyawa utawa kurang abot) ing individu tartamtu sing rentan.
Superinfeksi
Panganggone sing suwe bisa nyebabake kakehan organisme sing ora rentan, kalebu jamur. Yen superinfeksi kedadeyan, mandhegake persiapan neomycin lan miwiti terapi sing cocog.
Resistensi kanggo neomycin utawa anti-infèksi liyane ing preparat kombinasi tetep bisa berkembang.
Pancegahan sing Gegandhengan karo Administrasi Ophthalmic
Keratitis bakteri wis dikembangake ing pasien sing ora sengaja kontaminasi wadhah pirang-pirang dosis persiapan ophthalmic; ing kasus paling kacarita, penyakit kornea bebarengan utawa gangguan saka lumahing epiteli ocular ana.
Wawasan bisa sementara kabur sawise administrasi ophthalmic preparat topikal. Ati-ati ing operasi mesin utawa nyopir kendaraan bermotor.
Sawetara pabrikan ngati-ati yen salep ophthalmic bisa nundha penyembuhan.
Pancegahan sing Gegandhengan karo Administrasi Otik
Persediaan Otik sing ngemot neomycin, colistin, lan hydrocortisone acetate: Gunakake kanthi ati-ati ing pasien kanthi membran timpani perforasi.
Persediaan otik sing ngandhut neomycin, polimiksin B, lan hidrokortison: Aja digunakake ing pasien kanthi membran timpani perforasi.
Neomycin, utamane kanthi panggunaan sing dawa, bisa nyebabake gangguan pendengaran sensorineural permanen amarga karusakan koklea, utamane karusakan sel rambut ing organ Corti.
Gunakake preparat otic sing ngandhut neomycin mung ing pengamatan klinis sing cedhak; Aja nggunakake luwih saka 10 dina berturut-turut.
Yen digunakake kanggo ngontrol infèksi sekunder ing otitis externa kronis, nimbang yen kulit ing kondisi iki luwih tanggung jawab tinimbang kulit normal dadi sensitif marang akeh zat, kalebu neomycin. (Deleng Reaksi Hipersensitivitas ing Cautions.)
Yen infèksi otic ora apik sawise 1 minggu perawatan, njaluk kultur kanggo nuntun perawatan.
Panganggone Kombinasi Tetep sing Ngandhut Kortikosteroid
Nalika preparat ophthalmic utawa otic sing ngemot polimiksin B ing kombinasi tetep karo anti-infèksi liyane lan kortikosteroid (yaiku, deksametason, hidrokortison, hidrokortison asetat) digunakake, nimbang ati-ati. , pancegahan, lan kontraindikasi sing ana gandhengane karo kortikosteroid EENT.
Nyedhiyakake resep awal kanggo preparat ophthalmic kombinasi tetep sing ngemot kortikosteroid utawa resep pembaharuan (luwih saka 8 g salep mata utawa luwih saka 20 ml suspensi ophthalmic) mung sawise mriksa pasien kanthi mikroskop lampu celah lan, yen perlu, pewarnaan fluorescein.
Evaluasi maneh pasien yen nyeri mata utawa inflamasi tetep nganti> 48 jam utawa saya tambah.
Panganggone preparat ophthalmic sing berpanjangan sing ngemot kortikosteroid bisa nyebabake glaukoma, kanthi karusakan saraf optik, cacat ing ketajaman visual lan bidang penglihatan, lan pembentukan katarak subkapsular posterior. Yen digunakake kanggo ≥10 dina, ngawasi IOP kanthi rutin, sanajan ngawasi bisa uga angel kanggo bocah-bocah lan pasien sing ora kooperatif. Gunakake kanthi ati-ati ing pasien glaukoma; mriksa IOP kerep ing pasien kasebut.
Gunakake sawise operasi katarak bisa nundha penyembuhan lan nambah insiden pembentukan bleb.
Penipisan kornea lan scleral dilapurake kanthi macem-macem penyakit okular lan kanthi nggunakake jangka panjang kortikosteroid ophthalmic topikal. Panggunaan ing pasien kanthi jaringan kornea lan scleral tipis bisa nyebabake perforasi.
Panganggone sing suwe bisa nyuda respon host lan nambah risiko infeksi okular sekunder. Gunakake ing pasien kanthi kondisi purulen akut ing mripat bisa nutupi infeksi utawa nambah infeksi sing ana.
Bisa ndawakake kursus lan nambah keruwetan akeh infeksi virus ing mripat (kalebu herpes simplex). Gunakake ati-ati banget ing pasien karo herpes simplex; mikroskopi lampu irisan asring dianjurake.
Coba kemungkinan infèksi jamur ing kornea sawise nggunakake sing suwe, utamane ing pasien kanthi ulcerasi kornea sing terus-terusan. Nindakake kultur jamur yen cocok.
Populasi Tertentu
KandhutanOra dingerteni manawa preparat ophthalmic sing ngemot neomycin bisa nyebabake cilaka janin nalika diwenehake marang wanita ngandhut.
Neomycin lan anti-infèksi liyane (ophthalmic): Gunakake nalika meteng mung yen perlu.
Neomycin, anti-infèksi liyane, lan Dexamethasone, hydrocortisone, utawa hydrocortisone acetate (ophthalmic): Gunakake nalika meteng mung yen keuntungan potensial mbenerake potensial risiko kanggo janin.
Neomycin, colistin, lan hydrocortisone acetate (otic): Gunakake nalika meteng mung yen keuntungan potensial mbenerake potensial risiko kanggo janin. Sanajan aminoglikosida bisa nyebabake budheg kongenital ing manungsa yen diwenehake nalika meteng, pabrikan nyatakake yen konsentrasi sistemik neomycin sing penting sacara klinis ora diantisipasi nalika preparat otik sing ngemot neomycin digunakake kaya sing diarahake.
Neomycin, polymyxin B, lan hydrocortisone (otik): Gunakake nalika meteng mung yen keuntungan potensial mbenerake potensial risiko kanggo janin.
LaktasiOra dingerteni manawa neomycin disebarake menyang susu.
Neomycin lan anti-infèksi liyane (ophthalmic): Gunakake kanthi ati-ati.
Neomycin, polymyxin B, lan dexamethasone (oftalmik): Gunakake kanthi ati-ati.
Neomycin, polymyxin B, bacitracin, lan hydrocortisone utawa hydrocortisone acetate (ophthalmic): Mungkasi nyusoni utawa obat kasebut, kanthi nganggep pentinge obat kasebut kanggo wong wadon.
Neomycin, colistin, lan hydrocortisone acetate (otic): Gunakake kanthi ati-ati.
Neomycin, polimiksin B, lan hidrokortison (otik): Gunakake kanthi ati-ati.
Panggunaan PediatrikNeomycin, polymyxin B, lan bacitracin utawa gramicidin (ophthalmic): Keamanan lan khasiat ora ditetepake ing pasien pediatrik.
Neomycin, polymyxin B, lan dexamethasone (ophthalmic): Keamanan lan khasiat suspensi ora ditetepake ing bocah-bocah <2 taun; safety lan khasiat salep ora ditetepake ing pasien pediatrik.
Neomycin, polymyxin B, bacitracin, lan hydrocortisone utawa hydrocortisone acetate (ophthalmic): Keamanan lan khasiat ora ditetepake ing pasien pediatrik.
Neomycin, colistin, lan hydrocortisone acetate (otic): Keamanan lan khasiat ora ditetepake ing bocah-bocah <1 taun.
Neomycin, polymyxin B, lan hydrocortisone (otik): Umume pabrikan nyatakake safety lan khasiat sing ora ditetepake ing bocah-bocah <2 taun amarga data sing ora cukup. Salah sawijining pabrikan nyatakake safety lan khasiat wis ditetepake ing pasien pediatrik lan ora nemtokake kisaran umur.
Panggunaan GeriatrikNeomycin, polymyxin B, lan gramicidin (ophthalmic): Data klinis ora cukup kanggo nemtokake manawa pasien geriatrik nanggapi kanthi beda. saka wong diwasa enom; pengalaman klinis liyane durung nemtokake beda ing respon.
Neomycin, polymyxin B, lan dexamethasone (ophthalmic): Ora ana beda sakabèhé ing safety utawa khasiat relatif kanggo patients enom.
Neomycin, polymyxin B, bacitracin, lan hydrocortisone acetate (oftalmik): Ora ana beda sakabèhé ing safety utawa khasiat relatif kanggo wong diwasa enom.
Neomycin, colistin, lan hydrocortisone acetate (otic) : Ora ana beda sakabèhé ing safety utawa khasiat relatif kanggo wong diwasa enom.
Neomycin, polymyxin B, lan hydrocortisone (otic): Data klinis ora cukup kanggo nemtokake manawa pasien geriatrik nanggapi beda karo pasien sing luwih enom; pengalaman klinis liyane durung ngenali beda ing respon.
Efek Umum sing Sabar
Iritasi lokal lan reaksi alergi.
Disclaimer
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